Healthcare Provider Details

I. General information

NPI: 1275466195
Provider Name (Legal Business Name): KATHLEEN CHOR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 LONGWOOD AVE
BOSTON MA
02115-5804
US

IV. Provider business mailing address

17 FLORENCE ST APT 273
MALDEN MA
02148-3982
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-2850
  • Fax:
Mailing address:
  • Phone: 585-747-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06260137
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: